Which modification is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JI

Choice A reason:

Adequate oxygenation is important in managing vaso-occlusive sickle cell crisis, but the replacement of factor V is not relevant to this condition. Factor V is involved in the blood clotting process, and its replacement is typically associated with bleeding disorders such as hemophilia. Therefore, this choice is not appropriate for managing a vaso-occlusive crisis.

Choice B reason:

Adequate hydration and pain management are critical components of care for a child in vaso-occlusive sickle cell crisis. Hydration helps to reduce the viscosity of the blood, which can prevent further sickling of red blood cells and improve blood flow. Pain management is essential because vaso-occlusive crises are extremely painful and require prompt and effective pain relief, often with opioid analgesics. These measures help to alleviate symptoms and prevent complications.

Choice C reason:

Pain management is indeed a crucial aspect of care for vaso-occlusive sickle cell crisis, but the administration of heparin is not typically part of the treatment. Heparin is an anticoagulant used to prevent blood clots, and it is not indicated for managing vaso-occlusive crises. The focus should be on hydration and pain relief rather than anticoagulation.

Choice D reason:

Correction of acidosis may be necessary in some cases, but it is not the primary focus of care for vaso-occlusive sickle cell crisis. The main goals are to manage pain and ensure adequate hydration to improve blood flow and reduce the risk of further sickling of red blood cells. While addressing acidosis can be part of the overall management, it is not the primary intervention.

The correct answer is

A. Unable to roll over back to front

B. Head lag

C. Feeding difficulties

D. Floppy posture

E. Arms are stiff

F. Does not smile

G. Unable to sit without support

H. Irritable and cries often

I. Unable to pass an object between hands

Choice A reason

Unable to roll over back to front: At 3 months, infants typically start to develop the ability to roll over from their stomach to their back. Rolling over from back to front usually occurs later, around 4 to 6 months. However, the inability to roll over at all by 3 months could indicate developmental delays or muscle weakness, which requires follow-up.

Choice B Reason

Head lag: By 3 months, infants should have enough neck muscle strength to hold their head up when pulled to a sitting position. Persistent head lag at this age can be a sign of developmental delay or neuromuscular disorders, necessitating further evaluation.

Choice C Reason

Feeding difficulties: Infants should be able to suck and swallow effectively by 3 months. Feeding difficulties can lead to inadequate nutrition and growth, and may indicate underlying issues such as gastrointestinal problems or neurological disorders. This requires prompt attention and intervention.

Choice D Reason

Floppy posture: A 3-month-old should start to show more control over their body movements and have a more stable posture. Floppy posture, also known as hypotonia, can be a sign of various conditions, including genetic disorders, muscle diseases, or central nervous system issues. It is important to investigate the cause of hypotonia.

Choice E Reason

Arms are stiff: Stiffness in the arms, or hypertonia, can indicate neurological problems such as cerebral palsy or other motor disorders. It is crucial to assess the underlying cause of increased muscle tone and provide appropriate interventions.

Choice F Reason

Does not smile: Social smiling typically begins around 6 to 8 weeks of age. If a 3-month-old does not smile, it could be a sign of developmental delay, visual impairment, or other social and emotional issues. This warrants further assessment to determine the cause.

Choice G Reason

Unable to sit without support: While sitting without support is not expected until around 6 months, the inability to show any signs of trying to sit or maintain a sitting position with support at 3 months could indicate developmental delays. This should be monitored and addressed if necessary.

Choice H Reason

Irritable and cries often: Excessive irritability and frequent crying can be signs of discomfort, pain, or underlying medical conditions such as infections, gastrointestinal issues, or neurological problems. It is important to identify and address the cause of the infant’s distress.

Choice I Reason

Unable to pass an object between hands: By 3 months, infants should start to develop hand-eye coordination and the ability to grasp objects. The inability to pass an object between hands may indicate developmental delays or motor skill issues, which require further evaluation.